Behavioral Intervention Plan Form

Name: Kevin Montefalco Date: March 30, 2022

School: University of Bohol Grade: 5

This Behavioral Intervention Plan (BIP) is being created in response to exhibited persistent and/or severe

behavior that 1) interferes with the student’s learning or the learning of others and 2) warrants interventions

to positively redirect the targeted behavior. This BIP identifies the type and cause of the behavior, the

replacement behavior, positive interventions and support to reinforce the replacement behavior, and

appropriate consequences. The plan defines how the student will be taught the skills needed for behavior

modification and provisions for monitoring progress and crisis management.

Problem Behavior Frequency Intensity Duration

Kevin knocks Sally's book Every time for Math Mildly disruptive Until intervention by his teacher.
off her desk. worksheets.

General Academic Issues: FUNCTIONS of the Behaviors:

✔️work is too hard
What purpose does the
__not enough practice
identified behavior(s) seem to
__not enough help
serve for the child?
__not generalized skill
____ Escape
General Behavior Issues:
_____Avoid a demand or request
✔️Lacks ability to perform expected behavior
✔️Avoid an activity
__needs practice or modeling
_____Avoid a person
__Requires more structure
_____Escape the school
__Cannot apply across settings
_____Other
General Communication Issues:
________ Sensory/Perceptual
✔️to request assistance
_________Automatic sensory stimulation
__to request a break
_____Perceptual reinforcement
__to indicate a need
✔️Attention/ Control
✔️to indicate frustration
✔️Gain adult attention

✔️Gain peer attention

_____Get sent to a preferred adult

_____Other

___ Gain Desired Item

✔️Get desired item/activity/area

List:______________________
Intervention Strategies
1. Environment and/or Circumstances
How can the environment or circumstances that trigger the behavior (or the result of it) be
adjusted?
• I think the Math worksheets are difficult to answer that trigger the behaviour of the
student. Thus, allow the worksheets that can easily be answered by the student.
Staff Responsibility: Print readable, and easy to understand Math worksheets that are
appropriate for their grade and knowledge.

Student Responsibility: Ask assistance from the teacher in-charge to explain the difficult worksheets.
2. Curriculum and/or Instruction
What changes in the curriculum and/or instructional strategies will be helpful, and who will make it
happen?
• Make the Math worksheets fun and interactive so that Kevin's behaviour will not be mildly
disruptive to his peers. The teacher-in-charge will solely make it happen.
Staff Responsibility: Research Math activities and worksheets in the internet that make a fantastic way
for student to practice and consolidate math skills, but in a non-threatening and highly motivational
way.
Student Responsibility: Be participative and engage yourself to learn Math.
3. Other Strategies or Positive Supports (including school personnel, peers, or family)
• Teacher-in-charge can help the student by explaining the worksheet in a gently way.
• Peer-to-peer teaching can also help Kevin in his problem on his Math worksheet.
• Family, give enough attention to your child by tutoring him on his Math lessons.
Staff Responsibility: Has a long patience explaining Math to the student who had difficulty on this subject until he
will understand it.
Student Responsibility: The student must listen to the teacher attentively and focus on the Math worksheets.

Desired Replacement Behavior

What behavior will be taught to replace the targeted behaviors? How will it be taught/re-taught/reinforced, and
by who?
• Kevin will raise his hand to ask assistance to his teacher on his Math worksheets and wait for the teacher
when it is now his turn.
• Kevin will count 1-10 to minimize his frustration in answering Math worksheets.
• Let Kevin walk in the hallway for not more than one (1) minute.
• Tape a visual reminder of the replacement behaviour on the corner of Kevin's desk.
• Teacher will use a token board reward system with Kevin each time one of the replacement behaviours
occur.

Consequences
What consequences will be implemented for repeated occurrences of the problem
behavior?
1st Occurrence— Verbally remind Kevin of expectation. ( Ex. "It is okay to be frustrated
when answering worksheets. How can we solve the problem?")
2nd Occurrence— Reinforce any desired behaviour at a higher rate to redirect him to receive positive attention.
(Ex. enhale and exhale from 1-10 to minimize the frustration)
3rd Occurrence— Take Kevin in the hallway to cool down. A breather walk can occur but for no more than one (1)
minute.
 Crisis Plan
How will an emergency situation or behavior crisis be handled?
• Speak to the student directly, maintain eye contact, and remind him who you are and that you're there to
help. Alao, call his parent so that they will attempt to reorient and refocus their child by keeping him calm and
provide emotional support to him.

Crisis Team: For behaviors that threaten the safety of the child or of others, the Crisis Team will be called and
procedures implemented as per Policy 4373.

Monitoring of Behaviors (How the behaviors will be assessed and evaluated):

What data will be collected: Daily Log of Kevin's Behaviour
How it will be collected: Cool paint charts will be used daily as data for number of mild disruption of Kevin and
graphed on a frequency chart. If no progress after two (2) weeks, plan will be modified.
Who will collect it: Case Manager, Teacher-in-charge
How will parents be notified of progress: Give some feedback to the family through letters, email, or text
messages. Also, personally inform the parent during parent-teachers meeting so that they will know the progress
of thier child's behaviour in the class.
Date the plan will be reviewed: April 14, 2022

Date the plan will be reviewed: April 14, 2022

Signature of Parent: _____________________________________

Date: March 30, 2022

Signature of Staff:

I have reviewed this behavior intervention plan and am knowledgeable of my duties in its implementation.

Administrator:________________________ Date: March 30, 2022

Regular Educator: Emelyn L. Pangan Date: March 30, 2022
Special Educator: Emelyn L. Pangan Date: March 30, 2022
Other: ______________________________ Date:___________________________
Other:_______________________________ Date:___________________________